Provider Demographics
NPI:1427055474
Name:WHITE, CURTIS D (MD)
Entity type:Individual
Prefix:
First Name:CURTIS
Middle Name:D
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 449
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-0449
Mailing Address - Country:US
Mailing Address - Phone:740-374-4500
Mailing Address - Fax:740-374-5887
Practice Address - Street 1:807 FARSON ST
Practice Address - Street 2:SUITE 202
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-1068
Practice Address - Country:US
Practice Address - Phone:740-423-3222
Practice Address - Fax:740-401-0435
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV10863207VG0400X
OH35050256207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0552852Medicaid
OHP01022725OtherRRMCR
WV0094653000Medicaid
OH4146141Medicare PIN
WV0094653000Medicaid
OH0552852Medicaid
OHH052281Medicare PIN